clinical research of 1.8mm microincision phacoemulsification and intraocular lens implantation combined with trabeculectomy

METHODS: In this prospective study, 36 patients(36 eyes)with glaucoma and cataract in Inner Mongolia Autonomous Regian People's Hospital were collected and randomly divided into 2 groups. For the small incision group: 18 cases(18 eyes)underwent 3.0mm coaxial incision phacoemulsification-trabeculetomy with foldable IOL implantion; In th microincision group: 18 cases(18 eyes)underwent 1.8mm microincision phacoemulsification-trabeculetomy with ultra-thin IOL implantion. The two groups were recorded for 1wk, 1 and 3mo of visual acuity, corneal endothelial cell density, surgically induced astigmatism, intraocular pressure(IOP), filtering bleb and complications. Pearson's Chi-square test ande t-test were used to determine differences between the two groups.

RESULTS: At 1wk postoperatively, visual acuity in the microincision group was better than that of small incision group, the difference was statistically significant(P<0.05). At 1 and 3mo, the difference in corrected visual acuity between the 2 groups had no significant difference(P>0.05). At 1wk, 1 and 3mo, there was a significant different between the 2 groups in surgically induced astigmetism(P<0.05). At 1wk postoperatively, there was a significant difference in corneal endothelial cells density between 2 groups(P<0.05). But there were no significant difference at 1 and 3mo(P>0.05). IOP reduced after surgy(microincision group: 15.26±3.12mmHg, small incision group: 14.57±2.86mmHg), there was no significant difference between the 2 groups(P>0.05). There was no significant different between the 2 groups in blebs(P>0.05). Neither iris injury, posterior capsule rupture nor anterior chamber bleeding complications was found in any groups.

CONCLUSION: TBy compared with traditional 3.0mm coaxial small incision phacoemulsification-trabeculectomy with foldable IOL implantion, 1.8mm microincision phacoemulsification-trabeculectomy withe ultra-thin IOL implantion can effectively reduce the astigmatism operation. This operation is safe, effective, convenient surgy for treating cataract and glaucoma.